title: Mifepristone as a therapeutic agent in psychiatry.
abstract: The hypothalamic-pituitary-adrenal (HPA) axis is the body's main stress-response system, and cortisol is the major adrenal glucocorticoid hormone secreted in human beings. HPA axis activity and cortisol secretion is regulated by a negative feedback system involving glucocorticoid receptors. Dysregulation of the HPA axis and increased cortisol levels have been implicated in mood, psychotic, and other psychiatric disorders. Mifepristone, as a potent antagonist of glucocorticoid receptors, has been studied or is currently being investigated as a potential therapeutic agent for psychotic depression, posttraumatic stress disorder, and alcohol and cocaine dependence, as well as for mitigating the weight gain associated with the use of antipsychotic drugs and for improving cognitive dysfunction in schizophrenia and bipolar disorder. This article will review some of the work in these areas.
authors.affiliation: University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, Pittsburgh, Pennsylvania 15213, USA. HowlandRH@upmc.edu
authors.forename: Robert H
authors.initials: RH
authors.lastname: Howland
mesh_terms: D000341:Affective Disorders, Psychotic / Q000188:drug therapy / Q000451:nursing; D000437:Alcoholism / Q000188:drug therapy / Q000451:nursing; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D019970:Cocaine-Related Disorders / Q000188:drug therapy / Q000451:nursing; D006727:Hormone Antagonists / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000503:physiopathology; D001523:Mental Disorders / Q000188:drug therapy* / Q000451:nursing* / Q000503:physiopathology; D015735:Mifepristone / Q000009:adverse effects / Q000627:therapeutic use*; D010913:Pituitary-Adrenal System / Q000187:drug effects* / Q000503:physiopathology; D011618:Psychotic Disorders / Q000188:drug therapy / Q000451:nursing; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy / Q000451:nursing; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D006727:Hormone Antagonists; D015735:Mifepristone; D006854:Hydrocortisone